Isolation Precautions for Disseminated Herpes Zoster

NursingInfection Control and Isolation PrecautionsHard

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For each client, click to specify which precaution (airborne, contact, droplet, or standard) the nurse should use when caring for that client. Each client may require more than one type of precaution, or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row. History: Client is currently receiving outpatient chemotherapy for colon cancer. Last round of chemotherapy was held due to client's WBC of 1,000 $mm^3$ (5,000 to 10,000 $mm^3$). Client reported 3 days ago that they were itchy along the right rib cage, but no rash was noted. Client called the office today to report multiple blisters on their side, back and chest. They also stated they have a fever. Client admitted with a diagnosis of disseminated herpes zoster infection. Numerous vesicles noted on face, shoulders, chest, back and buttocks. Some vesicles are weeping clear fluid. Vital Signs: Temperature $38.8^\circ C$ ($101.8^\circ F$), Heart rate 96/min, Respiratory rate 20/min, Blood pressure 110/74 mm Hg.

This question includes visual content: The image shows an interactive web-based question interface. On the left, it provides a 'History' of a client with colon cancer receiving chemotherapy, who now has a diagnosis of disseminated herpes zoster, including specific symptoms and vital signs. On the right, there is a grid/matrix designed for selecting precautions (Airborne, Contact, Droplet, Standard) for five different clients. Client #1 is already selected for 'Contact Precautions' and 'Standard Precautions'. The grid has rows for Client #1 to Client #5 and columns for the four types of precautions, with checkboxes for user input.

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Step by Step Written Solution

1
Step 1

In this nursing practice question, we are asked to determine the correct transmission-based precautions for a specific patient, labeled as Client Two in the context provided.

Transmission-Based Precautions Analysis

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Step 2

Let's look closely at the history for Client number two. This client has several critical indicators: a diagnosis of disseminated herpes zoster, numerous fluid-filled vesicles on the face and body, and a low white blood cell count of one thousand per cubic millimeter.

Clinical Findings - Client #2

- Diagnosis: Disseminated Herpes Zoster (Shingles)

- Physical Exam: Numerous vesicles on face, shoulders, chest, back, and buttocks; weeping clear fluid.

- WBC Count: $1000$ $mm^3$ (Neutropenic)

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Step 3

First, we consider Standard Precautions. These are the basic level of infection control that must be used in the care of all patients in all healthcare settings, regardless of their suspected or confirmed infection status.


1. Standard Precautions

Required for all patients.

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Step 4

Next, let's analyze the diagnosis of disseminated herpes zoster. Unlike localized shingles, disseminated shingles involves lesions in multiple areas and requires strict isolation.

2. Disseminated Herpes Zoster Isolation

- Airborne Precautions: Required because the virus can be aerosolized, especially when lesions are extensive.

- Contact Precautions: Required due to direct contact with weeping fluid from vesicles.

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About This Question

Subject
Nursing
Topic
Infection Control and Isolation Precautions
Difficulty
Hard
Question Type
Matching

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